The Journal of Bone and Joint Surgery (American). 2010;92:16-22.
doi:10.2106/JBJS.I.00474
© 2010 The Journal of Bone and Joint Surgery, Inc.
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Outcomes of an Anatomic Posterolateral Knee Reconstruction

Robert F. LaPrade, MD, PhD1, Steinar Johansen, MD2, Julie Agel, MA1, May Arna Risberg, PT, PhD2, Havard Moksnes, PT2 and Lars Engebretsen, MD, PhD2

1 Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue, R200, Minneapolis, MN 55454. E-mail address for R.F LaPrade: lapra001{at}umn.edu
2 Department of Orthopaedic Surgery, Ullevaal University Hospital, University of Oslo, N-0407 Oslo, Norway

Investigation performed at the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, and the Department of Orthopaedic Surgery, Ullevaal University Hospital, University of Oslo, Oslo, Norway

A commentary by James P. Stannard, MD, is available at www.jbjs.org/commentary and as supplemental material to the online version of this article.

A video supplement to this article will be available from the Video Journal of Orthopaedics. A video clip will be available at the JBJS web site, www.jbjs.org. The Video Journal of Orthopaedics can be contacted at (805) 962-3410, web site: www.vjortho.com.

Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants of less than $10,000 from the University of Oslo School of Medicine Orthopaedic Center. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Background Chronic posterolateral knee injuries often result in substantial patient morbidity and functional instability. The clinical stability and functional outcomes following anatomic reconstructions in patients with a chronic posterolateral knee injury have not been determined, to our knowledge.

Methods A two-center outcomes study of sixty-four patients with grade-3 chronic posterolateral instability was performed. The patients were evaluated subjectively with the modified Cincinnati and International Knee Documentation Committee (IKDC) subjective scores and objectively with the IKDC objective score.

Results Eighteen patients had an isolated posterolateral knee reconstruction, and forty-six patients underwent a single-stage multiple-ligament reconstruction that included reconstruction of one or both cruciate ligaments along with the posterolateral knee reconstruction. The average duration of follow-up was 4.3 years. The fifty-four patients who were available for follow-up had an average total Cincinnati score of 65.7 points. A significant improvement was found between the preoperative and postoperative IKDC objective scores for varus opening at 20°, external rotation at 30°, reverse pivot shift, and single-leg hop.

Conclusions An anatomic posterolateral reconstruction resulted in improved clinical outcomes and objective stability for patients with a grade-3 posterolateral knee injury.

Level of Evidence Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


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M. McCarthy, L. Camarda, C. A. Wijdicks, S. Johansen, L. Engebretsen, and R. F. LaPrade
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[Abstract] [Full Text] [PDF]

Letters to the Editor:

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Regarding LaPrade et al., “Outcomes of an Anatomic Posterolateral Knee Reconstruction”
Frank R. Noyes, MD
JBJS Online, 11 May 2010 [Full text]
Dr. LaPrade and colleagues respond to Dr. Noyes
Robert F. LaPrade, MD, PhD, et al.
JBJS Online, 11 May 2010 [Full text]
Is the Reconstruction Really Anatomical?
Sunil Apsingi, et al.
JBJS Online, 26 Aug 2010 [Full text]
Dr. LaPrade and colleagues respond to Drs. Apsingi and Eachampati
Robert F. LaPrade, MD, PhD, et al.
JBJS Online, 26 Aug 2010 [Full text]